Individual
DR. JONATHAN CAMERON CROOKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
937 E HAVERFORD RD, SUITE 101, BRYN MAWR, PA 19010-3800
(610) 520-2490
(610) 520-2492
Mailing address
937 E HAVERFORD RD, SUITE 101, BRYN MAWR, PA 19010-3800
(610) 520-2490
(610) 520-2492
Taxonomy
Speciality
Code
Description
License number
State
111NI0013X
Independent Medical Examiner Chiropractor
DC009554
PA
111NS0005X
Sports Physician Chiropractor
Primary
DC009554
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
273309601
TAX IDENIFICATION NUMBER
PA
Enumeration date
11/06/2006
Last updated
11/09/2012
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